The Heart Attack Survival Kit Project. A public education campaign delivered by emergency medical services personnel to increase appropriate responses to symptoms of acute myocardial infarction (AMI) among seniors. Objectives: Acute myocardial infarction is the leading cause of death for Americans. Two critical actions a patient can take when faced with AMI symptoms are: 1) seeking prompt medical care, preferably by calling 911 so therapy can begin soon after onset of AMI and 2) taking an aspirin at onset of a heart attack, The National Heart, Lung, and Blood Institute as well as the American Heart Association have endorsed these recommendations. However, many AMI patients do not follow these life-saving actions. Strategies to increase the proportion of AMI patients engaging in these life-saving actions are needed. Specific Aims: To test the effectiveness of a Heart Attack Survival kit delivered door-to-door by emergency medical services (EMS) personnel to seniors. The specific aims are to increase appropriate responses (calling 911 and taking an aspirin) among persons age 65 years and older to heart attack symptoms. The secondary objectives are to assess if the intervention positively affects psychological and behavioral factors suggested by Leventhal's self-regulatory model. Design and Methods: King County, Washington (excluding the city of Seattle) will be divided into 120 geographically distinct "areas", located within 25 fire districts. These 120 "areas" will be randomized, stratified by fire district and size of area, to 60 intervention and 60 control areas. The intervention will consist of home delivery of the Heart Attack Survival Kit by firefighter EMS personnel. Unique to this project is the "house- call" and face-to-face discussion about heart attack preparation. Also unique is the inclusion of an aspirin in the kit. Data on 911 calls for chest pain and self-administration of aspirin will be collected from the medical incident report forms (MIRF), completed by EMS personnel. In addition to MIRF data collection, telephone surveys will be conducted with a sample of seniors 65 years or older in the study area to assess psychological and behavioral factors as suggested by self-regulatory theory. Outcome data will be collected for 2 years post-intervention. Pilot data suggest that home delivery of the kit by EMS personnel is a powerful intervention. If the intervention proves successful, it could be adapted and integrated into EMS systems throughout the country. The significance of this innovative study lies in the medical benefits that come from appropriate actions to symptoms of AMI as well as furthering our knowledge on how to effectively reach seniors with important health information.